Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Healthcare Inc

Organization Orthopaedic Surgery Physician · NPI 1760984033

Providence Healthcare Inc is an Orthopaedic Surgery Physician in Marina del Rey, California. Licensed in California. Registered with an NPI since 2018.

Licensed in
CA
In the registry since
2018
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13160 Mindanao Way
Marina del Rey, CA 90292-6358
Phone: (310) 437-7923
Fax: (310) 561-1927
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence G056259 (CA)

Record details

NPI number1760984033
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dean Matsuda — President · (310) 963-0994
NPI enumeratedMarch 2, 2018
Last updated in NPPESMarch 2, 2018
Mailing address214 Main St, El Segundo, CA 90245-3803

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